Neighborhoods and Perceived Norms: Understanding the Impact of Neighborhoods on Perceived Norms and Cancer Screening

ABSTRACT

This study examines the importance of urban ethnic neighborhoods as the context of everyday life, where normative influences on health are formed, modified, and maintained. Built on communication infrastructure theory, this study investigates the role of women’s connections to their neighborhood storytelling network—consisting of residents, local/ethnic media, and community organizations—in shaping their descriptive normative perceptions regarding cervical cancer screening. Specifically, we explore the communication mechanisms that underlie Latinas’ exposure and attention to media information about Pap tests, their discussions with health-care professionals about Pap tests, their perceptions about how normative Pap tests are among “women like them”, and their compliance with cervical cancer screening guidelines. Our findings suggest that neighborhood storytelling resources hold promise for health communication research to understand not only the uptake of Pap tests but also health disparities in other domains that affect diverse populations and communities.

Acknowledgments

The content is solely the responsibility of the authors and does not represent official views of the NCI or of the National Institutes of Health. The study protocol was reviewed and approved by the University of Southern California Health Science Institutional Review Board (#HS-11-00721).

Disclosure of potential conflicts of interest

The authors have no financial disclosures. The study sponsor had no role in study design; collection, analysis, and interpretation of data; writing the report; and the decision to submit the report for publication.

Supplementary material

Supplemental data for this article can be accessed on the publisher’s website.

Notes

¹ Detailed information about the ICSN measure is available from the corresponding author.

² Our measure of English media use was developed using dichotomous scores and was based on prior literature on communication infrastructure theory (Kim et al., 2011; Matsaganis & Wilkin, 2015). We additionally constructed a continuous measure and tested our conceptual model with it as a sensitivity check. To obtain the measure, we first standardized the constituent variables, added 1 to all entries such that they were all positive values, and then created the index of English media use by summing the values across all channels. Using the alternative measure, testing of the conceptual model generated an unsatisfactory fit to the data (χ² = 65.30, df = 37, p = .003, GFI = 1, CFI = .97, NFI = .93; RMSEA = .026, 90% CI = .015–.036) and did not differ significantly from the model using the original measure. For these reasons, this manuscript opted for the original measure in order to be consistent with prior literature.

³ A comparison of background characteristics between participants recruited at clinic sites versus those recruited at community sites is available in Online Supplemental Table 1.

Additional information

Funding

This work was supported by the National Cancer Institute for Barriers to Cervical Cancer Prevention in Hispanic Women: A Multilevel Approach, which was awarded to the University of Southern California [R01CA155326—Murphy/Ball-Rokeach].